J Gynecol Oncol.
2017 Sep;28(5):e69. 10.3802/jgo.2017.28.e69.
Malignant transformation of ovarian mature cystic teratoma into squamous cell carcinoma: a Taiwanese Gynecologic Oncology Group (TGOG) study
- Affiliations
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- 1Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
- 2Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan.
- 3Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.
- 4Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- 5Department of Obstetrics and Gynecology, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- 6Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan. clchang@mmc.edu.tw
- 7Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
- 8Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan.
- 9Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan.
- 10Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- 11Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.
- 12Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
- 13Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
- 14Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
- KMID: 2413229
- DOI: http://doi.org/10.3802/jgo.2017.28.e69
Abstract
OBJECTIVE
The malignant transformation (MT) of ovarian mature cystic teratoma (MCT) to squamous cell carcinoma (SCC) is very rare. This study analyzed cases from multiple medical centers in Taiwan to investigate the clinicopathologic characteristics, treatment, and prognostic factors of this disease and reviewed related literature.
METHODS
Pathological reports of 16,001 patients with primary ovarian cancer who were treated at Taiwan medical centers from 1990 to 2011 were reviewed. In total, 52 patients with MT of MCT to SCC were identified.
RESULTS
Among all ovarian MCTs, the incidence of MT to SCC is 0.2%. The median age of patients was 52 years (range, 29-89 years), and the mean tumor size was 10.5 cm (range, 1-40 cm). We analyzed the patients in our study and those in the literature and determined that early identification and complete surgical resection of the tumor are essential for long-term survival. In addition, adjuvant chemotherapy or concurrent chemoradiotherapy can be used to treat this malignancy. Old age, large tumor size (≥15.0 cm), and solid components in MCTs are suitable indicators predicting the risk of MT of MCT to SCC.
CONCLUSION
Similar to general epithelial ovarian cancers, the early detection of MT of MCT to SCC is critical to long-term survival. Therefore, older patients with a large tumor or those with a tumor containing a solid component in a clinically diagnosed MCT should be evaluated to exclude potential MT to SCC.
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